Skip to main content

Advertisement

SpringerLink
Log in

A mixed-methods study of the technical feasibility and patient acceptability of a real-time adherence monitor in breast cancer survivors taking adjuvant endocrine therapy

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose

Oral anti-cancer medications are increasingly common and endocrine therapies represent the most common oral anti-cancer medications in breast cancer. Adjuvant endocrine therapies reduce the likelihood of recurrence and mortality in the approximately 80% of women diagnosed with hormone-receptor-positive breast cancer, thus rendering adherence essential. Real-time medication adherence monitors, such as the Wisepill electronic pillbox, transmit adherence data remotely, allowing for early intervention for non-adherence. However, their feasibility and acceptability have yet to be examined among breast cancer survivors taking endocrine therapies.

Methods

This study presents quantitative patient-report and technical support data and qualitative patient acceptability data on Wisepill, a common real-time adherence monitor, among 88 breast cancer survivors prescribed adjuvant endocrine therapy.

Results

This mixed-methods study of a common real-time adherence monitor, among the first in breast cancer survivors taking adjuvant endocrine therapy, demonstrates its technical feasibility and patient acceptability.

Conclusion

The use of wireless medication monitors that transmit real-time adherence data is uniquely promising for maximizing the benefits of adjuvant endocrine therapy by allowing for continuous tracking, ongoing communication with oncologic or research teams, and early intervention. This study demonstrates the feasibility and patient acceptability of one such real-time adherence monitor.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

Upon reasonable request, the quantitative data analyzed in this study are available from the corresponding author in accordance with institutional policies. Qualitative data currently lack widely accepted de-identification standards.

References

  1. Weingart SN, Brown E, Bach PB et al (2008) NCCN Task Force Report: Oral Chemotherapy. J Nat Compr Cancer Netw. https://doi.org/10.6004/jnccn.2008.2003

    Article  Google Scholar 

  2. Murphy CC, Bartholomew LK, Carpentier MY, Bluethmann SM, Vernon SW (2012) Adherence to adjuvant hormonal therapy among breast cancer survivors in clinical practice: a systematic review. Breast Cancer Res Treat 134(2):459–478

    Article  CAS  Google Scholar 

  3. Ruddy K, Mayer E, Partridge A (2009) Patient adherence and persistence with oral anticancer treatment. CA A Cancer J Clin 59(1):56–66

    Article  Google Scholar 

  4. Partridge AH, Avorn J, Wang PS, Winer EP (2002) Adherence to therapy with oral antineoplastic agents. J Natl Cancer Inst 94(9):652–661

    Article  Google Scholar 

  5. Greer JA, Amoyal N, Nisotel L et al (2016) A systematic review of adherence to oral antineoplastic therapies. Oncologist 21(3):354–376

    Article  CAS  Google Scholar 

  6. Kaptein AA, Schoones JW, van der Meer PB et al (2021) Psychosocial determinants of adherence with oral anticancer treatment:‘we don’t need no education.’ Acta Oncol 60(1):87–95

    Article  Google Scholar 

  7. Kravitz RL, Melnikow J (2004) Medical adherence research: time for a change in direction? Med Care 42(3):197–199

    Article  Google Scholar 

  8. Dunnwald LK, Rossing MA, Li CI (2007) Hormone receptor status, tumor characteristics, and prognosis: a prospective cohort of breast cancer patients. Breast Cancer Res 9(1):R6

    Article  Google Scholar 

  9. Makubate B, Donnan PT, Dewar JA, Thompson AM, McCowan C (2013) Cohort study of adherence to adjuvant endocrine therapy, breast cancer recurrence and mortality. Br J Cancer 108(7):1515–1524

    Article  CAS  Google Scholar 

  10. Hershman DL, Kushi LH, Shao T et al (2010) Early discontinuation and nonadherence to adjuvant hormonal therapy in a cohort of 8,769 early-stage breast cancer patients. J Clin Oncol 28(27):4120–4128

    Article  Google Scholar 

  11. Burstein HJ, Temin S, Anderson H et al (2014) Adjuvant endocrine therapy for women with hormone receptor-positive breast cancer: American society of clinical oncology clinical practice guideline focused update. J Clin Oncol 32(21):2255–2269

    Article  Google Scholar 

  12. Pistilli B, Paci A, Ferreira AR et al (2020) Serum detection of nonadherence to adjuvant tamoxifen and breast cancer recurrence risk. J Clin Oncol 38(24):2762–2772

    Article  CAS  Google Scholar 

  13. Osterberg L, Blaschke T (2005) Adherence to medication. NEJM 353(5):487–497

    Article  CAS  Google Scholar 

  14. Haberer JE (2017) Actionable adherence monitoring to optimise intervention. Lancet HIV 4(1):e5–e6

    Article  Google Scholar 

  15. Kofoed S, Breen S, Gough K, Aranda S (2012) Benefits of remote real-time side-effect monitoring systems for patients receiving cancer treatment. Oncol Rev 6(1):e7

    Article  Google Scholar 

  16. Warrington L, Absolom K, Conner M et al (2019) Electronic systems for patients to report and manage side effects of cancer treatment: systematic review. J Med Internet Res 21(1):e10875

    Article  Google Scholar 

  17. Haberer JE, Kahane J, Kigozi I et al (2010) Real-time adherence monitoring for HIV antiretroviral therapy. AIDS Behav 14(6):1340–1346

    Article  Google Scholar 

  18. Evans D, Berhanu R, Moyo F, Nguweneza A, Long L, Fox MP (2016) Can short-term use of electronic patient adherence monitoring devices improve adherence in patients failing second-line antiretroviral therapy? Evidence from a pilot study in Johannesburg. South Africa AIDS Behav 20(11):2717–2728

    Article  Google Scholar 

  19. Arch JJ, Crespi CM, Levin ME et al (2022) Randomized controlled pilot trial of a low-touch remotely-delivered values intervention to promote adherence to adjuvant endocrine therapy among breast cancer survivors. Ann behav med. https://doi.org/10.1093/abm/kaab118

    Article  PubMed  Google Scholar 

  20. Haynes RB, Sackett DL (1979) Compliance in Health Care. Johns Hopkins University Press, Baltimore

    Google Scholar 

  21. Carpenter CJ (2010) A meta-analysis of the effectiveness of health belief model variables in predicting behavior. Health Commun 25(8):661–669

    Article  Google Scholar 

  22. Bachman DeSilva M, Gifford AL, Keyi X et al (2013) Feasibility and acceptability of a real-time adherence device among HIV-positive IDU patients in China. AIDS Res Treat. https://doi.org/10.1155/2013/957862

    Article  PubMed  PubMed Central  Google Scholar 

  23. Wendel CS, Mohler MJ, Kroesen K, Ampel NM, Gifford AL, Coons SJ (2001) Barriers to Use of Electronic Adherence Monitoring in an HIV Clinic. Ann Pharmacother 35(9):1010–1015

    Article  CAS  Google Scholar 

  24. Stringer KL, Azuero A, Ott C et al (2019) Feasibility and acceptability of real-time antiretroviral adherence monitoring among depressed women living with HIV in the deep south of the US. AIDS Behav 23(5):1306–1314

    Article  Google Scholar 

  25. Checchi KD, Huybrechts KF, Avorn J, Kesselheim AS (2014) Electronic medication packaging devices and medication adherence: a systematic review. JAMA 312(12):1237–1247

    Article  CAS  Google Scholar 

  26. Roberts MC, Wheeler SB, Reeder-Hayes K (2015) Racial/ethnic and socioeconomic disparities in endocrine therapy adherence in breast cancer: a systematic review. Am J Public Health 105(S3):e4–e15

    Article  Google Scholar 

  27. Nicholson LM, Schwirian PM, Groner JA (2015) Recruitment and retention strategies in clinical studies with low-income and minority populations: progress from 2004–2014. Contemp Clin Trials 45:34–40

    Article  Google Scholar 

  28. Kennedy BM, Kumanyika S, Ard JD et al (2010) Overall and minority-focused recruitment strategies in the PREMIER multicenter trial of lifestyle interventions for blood pressure control. Contemp Clin Trials 31(1):49–54

    Article  Google Scholar 

  29. McCowan C, Shearer J, Donnan PT et al (2008) Cohort study examining tamoxifen adherence and its relationship to mortality in women with breast cancer. Br J Cancer 99(11):1763–1768

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This work was supported by a grant from the National Cancer Institute, R21CA218723 (PI: Arch) and the Breast Cancer Research Foundation, BCRF-21-153 (PI: Stanton).

Funding

Division of Cancer Epidemiology and Genetics,National Cancer Institute,R21CA218723,Joanna J. Arch,International Breast Cancer Research Foundation,BCRF-21-153,Annette L Stanton

Author information

Authors and Affiliations

  1. Department of Psychology and Neuroscience, University of Colorado, Box 345, Boulder, CO, 80309-0345, USA

    Emma E. Bright, Sarah R. Genung & Joanna J. Arch

  2. Department of Psychology, University of California, Los Angeles, CA, USA

    Annette L. Stanton

  3. Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, USA

    Annette L. Stanton

  4. Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA

    Annette L. Stanton

Authors
  1. Emma E. Bright
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sarah R. Genung
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Annette L. Stanton
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Joanna J. Arch
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors have made substantial contributions to the conception and design of the work, including the acquisition, analysis, and interpretation of data, as well as drafting the manuscript. All authors have approved the current version of manuscript and are accountable for all aspects of the work.

Corresponding author

Correspondence to Emma E. Bright.

Ethics declarations

Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethics approval

University of Colorado Institutional Review Board approval was obtained for this study.

Consent to participate

Informed consent was obtained from all participants.

Consent for publication

Not applicable.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bright, E.E., Genung, S.R., Stanton, A.L. et al. A mixed-methods study of the technical feasibility and patient acceptability of a real-time adherence monitor in breast cancer survivors taking adjuvant endocrine therapy. Breast Cancer Res Treat 195, 393–399 (2022). https://doi.org/10.1007/s10549-022-06705-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-022-06705-1

Keywords

Search

Navigation